| 2. |
- Phu, Vu Dinh, et al.
(författare)
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Burden of Hospital Acquired Infections and Antimicrobial Use in Vietnamese Adult Intensive Care Units
- 2016
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Vietnam is a lower middle-income country with no national surveillance system for hospital-acquired infections (HAIs). We assessed the prevalence of hospital-acquired infections and antimicrobial use in adult intensive care units (ICUs) across Vietnam. Methods Monthly repeated point prevalence surveys were systematically conducted to assess HAI prevalence and antimicrobial use in 15 adult ICUs across Vietnam. Adults admitted to participating ICUs before 08: 00 a.m. on the survey day were included. Results Among 3287 patients enrolled, the HAI prevalence was 29.5% (965/3266 patients, 21 missing). Pneumonia accounted for 79.4% (804/1012) of HAIs Most HAIs (84.5% [855/1012]) were acquired in the survey hospital with 42.5% (363/855) acquired prior to ICU admission and 57.5% (492/855) developed during ICU admission. In multivariate analysis, the strongest risk factors for HAI acquired in ICU were: intubation (OR 2.76), urinary catheter (OR 2.12), no involvement of a family member in patient care (OR 1.94), and surgery after admission (OR 1.66). 726 bacterial isolates were cultured from 622/1012 HAIs, most frequently Acinetobacter baumannii (177/726 [24.4%]), Pseudomonas aeruginosa (100/726 [13.8%]), and Klebsiella pneumoniae (84/726 [11.6%]), with carbapenem resistance rates of 89.2%, 55.7%, and 14.9% respectively. Antimicrobials were prescribed for 84.8% (2787/ 3287) patients, with 73.7% of patients receiving two or more. The most common antimicrobial groups were third generation cephalosporins, fluoroquinolones, and carbapenems (20.1%, 19.4%, and 14.1% of total antimicrobials, respectively). Conclusion A high prevalence of HAIs was observed, mainly caused by Gram-negative bacteria with high carbapenem resistance rates. This in combination with a high rate of antimicrobial use illustrates the urgent need to improve rational antimicrobial use and infection control efforts.
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| 4. |
- le, Vinh Thanh
(författare)
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ENSO response to external forcing in CMIP5 simulations of the last millennium
- 2017
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Ingår i: Global and Planetary Change. - : Elsevier BV. - 0921-8181. ; 148, s. 105-112
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Tidskriftsartikel (refereegranskat)abstract
- The El Niño–Southern Oscillation (ENSO) is dominant mode of interannual climate variability, but its response to external climate forcings remains uncertain. Past studies have limitations including the use of short datasets and the uncertainty contained in reconstructions or simulations of past ENSO variations. To improve our understanding on ENSO variations, it is important to examine its response to these forcings by using multi model simulations since they provide longer datasets and help improving the statistical significance of the results. In this study, Granger causality test is applied to investigate the influence of external forcings on ENSO by using past millennium simulations (period 850–1850 CE) of Coupled Model Intercomparison Project Phase 5 (CMIP5) models. The results show robust influence of volcanic forcing to ENSO during preindustrial times of last millennium. The response of ENSO to solar forcing is more likely to be weak. Detection of GHGs variations signal in ENSO response is not significant. However, this study also indicates that there are uncertainties in the responses of ENSO to solar forcing and GHGs radiative forcing. The possibility of the true causal connection between Total Solar Irradiance (TSI) or GHGs radiative forcing and ENSO cannot be rejected at 95% significance level.
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